IPXP Transition

On July 1, 2013, operation of the Illinois Pre-Existing Condition Insurance Plan (IPXP) is transitioning to the federally run Pre-Existing Condition Insurance Plan (PCIP). Members should watch for a letter from the federal government that includes the PCIP Enrollment Form (shown below). PCIP coverage runs through December 2013.

Some of the coverage highlights of IPXP include:

Preexisting conditions are covered.

Choice of four calendar year deductibles: $500, $1,000, $2,000 or $5,000.

PPO coverage.

Prescription drugs covered without a deductible (except for the $5,000 deductible plan) with an out-of-pocket maximum of $1,600 per calendar year. Services other than prescription drugs subject to calendar year deductible.

Coinsurance for all services is 20% with the $500, $1,000 and $2,000 deductible plan (for non-preferred PPO providers coinsurance is 40%). With the $5,000 deductible plan, there’s no coinsurance after the deductible is met (for non-preferred PPO providers coinsurance is 20%).

Calendar year out-of-pocket limits: Out-of-pocket expenses are limited each calendar year for major medical expenses.